英国伦敦西北部临床调试组对1型糖尿病患者持续血糖监测和低血糖认知受损的经济评价

Q2 Medicine European Endocrinology Pub Date : 2017-08-01 Epub Date: 2017-08-22 DOI:10.17925/EE.2017.13.02.81
Shraddha Chaugule, Nick Oliver, Brigitte Klinkenbijl, Claudia Graham
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引用次数: 10

摘要

评估在伦敦西北(NW)临床调试组(ccg)中为1型糖尿病(T1D)和低血糖意识受损(IAH)患者提供实时连续血糖监测(CGM)的经济影响。方法:符合CGM的人口和经济预算影响模型的输入来自已发表的数据。该模型包括CGM的成本;与低血糖相关的住院、事故和急诊就诊减少相关的成本节约;自我监测血糖试纸使用情况;糖化血红蛋白(HbA1c)降低相关的避免并发症和胰岛素泵的使用。结果:T1D-IAH (n=3,036)第一年的CGM费用为10,770,671英镑,第四年为11,329,095英镑。在第一年和第四年,与降低低血糖入院率、SMBG条使用率和并发症相关的综合成本抵消分别为8,116,912英镑和8,741,026英镑。NW伦敦CCGs的净预算影响为2,653,760英镑;第一年和第四年分别为2,588,068英镑。结论:在T1D-IAH患者中引入CGM将对NW伦敦CCGs的预算影响最小,这是由于CGM的成本和较低的低血糖相关成本、减少的SMBG条带使用、避免hba1c相关并发症和较低的胰岛素泵使用所抵消的。
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An Economic Evaluation of Continuous Glucose Monitoring for People with Type 1 Diabetes and Impaired Awareness of Hypoglycaemia within North West London Clinical Commissioning Groups in England.

To assess the economic impact of providing real time continuous glucose monitoring (CGM) for people with type 1 diabetes (T1D) and impaired awareness of hypoglycaemia (IAH) within North West (NW) London clinical commissioning groups (CCGs).

Methods: The eligible population for CGM and inputs for the economic budget impact model developed were derived from published data. The model includes cost of CGM; cost savings associated with lower hypoglycaemia related hospital admissions, accidents and emergency visits; self-monitoring of blood glucose (SMBG) strip usage; and glycated haemoglobin (HbA1c) reduction-related avoided complications and insulin pump use.

Results: The cost of CGM for T1D-IAH (n=3,036) in the first year is £10,770,671 and in the fourth year is £11,329,095. The combined cost off-sets related to reduced hypoglycaemia admissions, SMBG strip usage and complications are £8,116,912 and £8,741,026 in years one and four, respectively. The net budget impact within the NW London CCGs is £2,653,760; £2,588,068 in years one and four respectively.

Conclusions: Introduction of CGM for T1D-IAH patients will have a minimal budget impact on NW London CCGs, driven by cost of CGM and offsets from lower hypoglycaemia-related costs, reduced SMBG strip usage, avoided HbA1c-related complications and lower insulin pump use.

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European Endocrinology
European Endocrinology Medicine-Endocrinology, Diabetes and Metabolism
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